title: The effect of Mediterranean diet on metabolic syndrome and its components: a meta-analysis of 50 studies and 534,906 individuals.
abstract: OBJECTIVE
  The aim of this study was to meta-analyze epidemiological studies and clinical trials that have assessed the effect of a Mediterranean diet on metabolic syndrome (MS) as well as its components.
  
  
  BACKGROUND
  The Mediterranean diet has long been associated with low cardiovascular disease risk in adult population.
  
  
  METHODS
  The authors conducted a systematic review and random effects meta-analysis of epidemiological studies and randomized controlled trials, including English-language publications in PubMed, Embase, Web of Science, and the Cochrane Central Register of Controlled Trials until April 30, 2010; 50 original research studies (35 clinical trials, 2 prospective and 13 cross-sectional), with 534,906 participants, were included in the analysis.
  
  
  RESULTS
  The combined effect of prospective studies and clinical trials showed that adherence to the Mediterranean diet was associated with reduced risk of MS (log hazard ratio: -0.69, 95% confidence interval [CI]: -1.24 to -1.16). Additionally, results from clinical studies (mean difference, 95% CI) revealed the protective role of the Mediterranean diet on components of MS, like waist circumference (-0.42 cm, 95% CI: -0.82 to -0.02), high-density lipoprotein cholesterol (1.17 mg/dl, 95% CI: 0.38 to 1.96), triglycerides (-6.14 mg/dl, 95% CI: -10.35 to -1.93), systolic (-2.35 mm Hg, 95% CI: -3.51 to -1.18) and diastolic blood pressure (-1.58 mm Hg, 95% CI: -2.02 to -1.13), and glucose (-3.89 mg/dl, 95% CI:-5.84 to -1.95), whereas results from epidemiological studies also confirmed those of clinical trials.
  
  
  CONCLUSIONS
  These results are of considerable public health importance, because this dietary pattern can be easily adopted by all population groups and various cultures and cost-effectively serve for primary and secondary prevention of the MS and its individual components.
authors.affiliation: Department of Nutrition Science-Dietetics, Harokopio University, Athens, Greece.
authors.forename: Christina-Maria
authors.initials: CM
authors.lastname: Kastorini
authors.forename: Haralampos J
authors.initials: HJ
authors.lastname: Milionis
authors.forename: Katherine
authors.initials: K
authors.lastname: Esposito
authors.forename: Dario
authors.initials: D
authors.lastname: Giugliano
authors.forename: John A
authors.initials: JA
authors.lastname: Goudevenos
authors.forename: Demosthenes B
authors.initials: DB
authors.lastname: Panagiotakos
mesh_terms: D002318:Cardiovascular Diseases / Q000178:diet therapy / Q000453:epidemiology; D002986:Clinical Trials as Topic / Q000379:methods; D003430:Cross-Sectional Studies; D038441:Diet, Mediterranean; D018450:Disease Progression; D006801:Humans; D024821:Metabolic Syndrome / Q000178:diet therapy* / Q000453:epidemiology*; D012307:Risk Factors